tbuckley/cabot-search huggingface dataset:
Assessment of Risk of Rheumatoid Arthritis Among Underground Hard Rock and Other Mining Industry Workers in Colorado, New Mexico, and Utah
Authors: Paul D. Blanc, Laura Trupin, Edward H. Yelin, Gabriela Schmajuk
Journal: JAMA Network Open (2022)

Importance Respirable silica exposure has been strongly and consistently linked to rheumatoid arthritis (RA) among foundry workers, persons in the construction trades, stone crushers and drillers, and coal miners. However, risk of RA in hard rock mining has not been thoroughly investigated. Objective To analyze occupational risk of RA in hard rock miners in Colorado, New Mexico, and Utah. Design, Setting, and Participants This cross-sectional survey study estimated the association between mining industry work and reported RA in a random-digit telephone survey of men 50 years or older living in selected counties with elevated levels of pneumoconiosis mortality (N = 1988). The survey was conducted between January 12 and May 4, 2021. Exposures Underground hard rock and other mining and related mineral-processing occupations. Main Outcomes and Measures Report of a clinician diagnosis of RA further defined by treatment with corticosteroids or disease-modifying antirheumatic drugs. Risk was estimated using logistic regression. Results The analytic sample of 1988 men (survey response rate, 11.1% of all contacts) had a mean (SD) age of 68.6 (10.1) years. Underground hard rock mining was reported by 118 (5.9%); underground mining of other types, predominantly coal mining (no concomitant hard rock), 62 (3.1%); and surface mining or ore processing (no underground), 262 (13.2%). Adjusting for age and smoking and accounting for nonmining silica exposure, mining employment was associated with increased odds of corticosteroid-treated RA (n = 89) (odds ratio, 4.12 [95%, 2.49-6.81]). The odds were similar for RA treated with disease-modifying antirheumatic drugs (n = 80) (odds ratio, 3.30 [95% CI, 1.93-5.66]). Conclusions and Relevance In this cross-sectional survey study, workers in hard rock and other underground mining and surface mining occupations experienced 3- to 4-fold increased odds of RA. These findings suggest that clinicians should consider patients with relevant work exposures as at higher risk for developing RA.
Clinician Diagnostic Certainty and the Role of the Autism Diagnostic Observation Schedule in Autism Spectrum Disorder Diagnosis in Young Children
Authors: William Barbaresi, Jaclyn Cacia, Sandra Friedman, Jill Fussell, Robin Hansen, Johannes Hofer, Nancy Roizen, Ruth E. K. Stein, Douglas Vanderbilt, Georgios Sideridis
Journal: JAMA Pediatrics (2022)

Autism spectrum disorder (ASD) affects 1 in 44 children. The Autism Diagnostic Observation Schedule (ADOS) is a semi-structured observation developed for use in research but is considered a component of gold standard clinical diagnosis. The ADOS adds time and cost to diagnostic assessments.To evaluate consistency between clinical diagnosis (index ASD diagnosis) and diagnosis incorporating the ADOS (reference standard ASD diagnosis) and to examine clinician and child factors that predict consistency between index diagnoses and reference standard diagnoses.This prospective diagnostic study was conducted between May 2019 and February 2020. Developmental-behavioral pediatricians (DBPs) made a diagnosis based on clinical assessment (index ASD diagnosis). The ADOS was then administered, after which the DBP made a second diagnosis (reference standard ASD diagnosis). DBPs self-reported diagnostic certainty at the time of the index diagnoses and reference standard diagnoses. The study took place at 8 sites (7 US and 1 European) that provided subspecialty assessments for children with concerns for ASD. Participants included children aged 18 months to 5 years, 11 months, without a prior ASD diagnosis, consecutively referred for possible ASD. Among 648 eligible children, 23 refused, 376 enrolled, and 349 completed the study. All 40 eligible DBPs participated.ADOS administered to all child participants.Index diagnoses and reference standard diagnoses of ASD (yes/no).Among the 349 children (279 [79.7%] male; mean [SD] age, 39.9 [13.4] months), index diagnoses and reference standard diagnoses were consistent for 314 (90%) (ASD = 250; not ASD = 64) and changed for 35. Clinician diagnostic certainty was the most sensitive and specific predictor of diagnostic consistency (area under curve = 0.860; P < .001). In a multilevel logistic regression, no child or clinician factors improved prediction of diagnostic consistency based solely on clinician diagnostic certainty at time of index diagnosis.In this prospective diagnostic study, clinical diagnoses of ASD by DBPs with vs without the ADOS were consistent in 90.0% of cases. Clinician diagnostic certainty predicted consistency of index diagnoses and reference standard diagnoses. This study suggests that the ADOS is generally not required for diagnosis of ASD in young children by DBPs and that DBPs can identify children for whom the ADOS may be needed.
Incidence of Kawasaki Disease Before and After the COVID-19 Pandemic in Japan
Authors: Ryusuke Ae, Nobuko Makino, Masanari Kuwabara, Yuri Matsubara, Koki Kosami, Teppei Sasahara, Yosikazu Nakamura
Journal: JAMA Pediatrics (2022)

Global studies have reported that the incidence of Kawasaki disease (KD) declined during the COVID-19 pandemic. These studies suggest that the global pandemic and its accompanying mitigation measures may provide an important opportunity to explore the hypothesis of a KD pathogenesis.To compare changes in KD incidence in Japan before and after the start of the COVID-19 pandemic.This cohort study was conducted using the data set from Japan's 26th nationwide KD survey that obtained information on patients who were diagnosed with KD in Japan from January 1, 2019, through December 31, 2020.Kawasaki disease incidence rates were calculated by referring to the national population data in the vital statistics data for Japan.A total of 28 520 patients were identified (16 236 male individuals [56.9%]; median [IQR] age, 26 [14-44] months). A total of 17 347 patients were diagnosed with KD in 2019 and 11 173 were diagnosed in 2020, representing a 35.6% reduction in the number of patients diagnosed in 2020 compared with the previous year. Patient distributions for days of illness at the first hospital visit were almost identical in 2019 and 2020, suggesting that the decrease in KD incidence likely was not associated with pandemic-related delays in seeking treatment. The proportion of patients diagnosed with KD who were younger than 12 months was significantly larger in 2020 than in 2019 (21.6% vs 19.4%; P < .001). Compared with KD incidence among younger patients, the incidence among those 24 months and older declined rapidly after initiation of COVID-19 special mitigation measures, with a greater percentage reduction (58.3% reduction in July), but rebounded faster after the end of the special mitigation period. By contrast, the incidence among patients younger than 12 months declined moderately after the initiation of the special mitigation period, with a lower percentage reduction (40.3% reduction in October), and rebounded at a later phase.In this cohort study, the number of patients diagnosed with KD decreased by approximately one-third across Japan in 2020, with no indication that parents avoided a hospital visit. Differences in KD incidence reduction patterns before and after the initiation of COVID-19 pandemic mitigation measures were found in patients with KD aged younger than 12 months compared with those 24 months or older, suggesting a potential KD pathogenesis involving transmission among children.
Gender-Affirming Chest Reconstruction Among Transgender and Gender-Diverse Adolescents in the US From 2016 to 2019
Authors: Rishub Karan Das, Galen Perdikis, Salam Al Kassis, Brian C. Drolet
Journal: JAMA Pediatrics (2022)

This cross-sectional study examines the incidence, demographic characteristics, and cost associated with masculinizing and feminizing chest surgical procedures among individuals younger than 18 years.
Amyotrophic Lateral Sclerosis Clinical Trials and Interpretation of Functional End Points and Fluid Biomarkers
Authors: Jeremy M. Shefner, Richard Bedlack, Jinsy A. Andrews, James D. Berry, Robert Bowser, Robert Brown, Jonathan D. Glass, Nicholas J. Maragakis, Timothy M. Miller, Jeffrey D. Rothstein, Merit E. Cudkowicz
Journal: JAMA Neurology (2022)

Clinical trial activity in amyotrophic lateral sclerosis (ALS) is dramatically increasing; as a result, trial modifications have been introduced to improve efficiency, outcome measures have been reassessed, and considerable discussion about the level of data necessary to advance a drug to approval has occurred. This review discusses what recent pivotal studies can teach the community about these topics.By restricting inclusion and exclusion criteria, recent trials have enrolled populations distinct from previous studies. This has led to efficacy signals being observed in studies that are smaller and shorter than was thought feasible previously. However, such trials raise questions about generalizability of results. Small trials with equivocal clinical results also raise questions about the data necessary to lead to regulatory approval. The ALS Functional Rating Scale-Revised remains the most commonly used primary outcome measure; this review discusses innovations in its use. Blood neurofilament levels can predict prognosis in ALS and may be a sensitive indicator of biologic effect; current knowledge does not yet support its use as a primary outcome.It is now possible to use specific inclusion criteria to recruit a homogeneous patient population progressing at a specific rate; this will likely impact trials in the future. Generalizability of results on limited populations remains a concern. Although clinical outcomes remain the most appropriate primary outcome measures, fluid markers reflecting biologically important processes will assume more importance as more is learned about the association between such markers and clinical end points. The benefit of use of analytic strategies, such as responder analyses, is still uncertain.
White
Authors: Hera Maryam
Journal: Annals of Internal Medicine (2022)

Ad LibitumOctober 2022WhiteHera Maryam, MD, BSHera Maryam, MD, BSInova Fairfax Fairfax, VirginiaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-4220 Audio Reading - “White” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “White” by Hera Maryam, MD, BS Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail What is the PEEPHe asksPacing aroundBig white and manlyHe had introduced himselfAs doctorShaking my hand firmlyAsking me about left diastolic heart pressuresAs his mother lay intubatedAt 83White hair and white skinHer head inclined to the rightIn resignationLips apartA tube seated firmlyHe walks aroundHis belly protrudingSelf-important, confidentProjectingRationalizingDemeaning (he had asked “what year are you?” Dismissing my lack of expertise)BoomingOn a phone call with some no-name executiveControlAs his mom lay dyingLike a crumpledSnow WhiteLike watercolorThat's too thinSpilling and collidingOn white paperMixingCreating blotchesSon and intensivistAt oddsPacing, clashingAround big blotches of ... Author, Article, and Disclosure InformationAuthors: Hera Maryam, MD, BSAffiliations: Inova Fairfax Fairfax, VirginiaCorresponding Author: Hera Maryam, MD, BS; e-mail, maryamhera@gmail.com. PreviousarticleNextarticle Advertisement Audio Reading - “White” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “White” by Hera Maryam, MD, BS Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics October 2022Volume 175, Issue 10Page: 1490 ePublished: 18 October 2022 Issue Published: October 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
SARS-CoV-2–Related Mitigation Measures and Insights Into Kawasaki Disease
Authors: Mary Beth F. Son, Jane W. Newburger
Journal: JAMA Pediatrics (2022)

Ryusuke Ae, MD, PhD; Nobuko Makino, MD, PhD; Masanari Kuwabara, MD, PhD; Yuri Matsubara, MD; Koki Kosami, MD; Teppei Sasahara, MD, PhD; Yosikazu Nakamura, MD, MPH
Prevention of infections including vaccination strategies in multiple myeloma
Authors: Heinz Ludwig, Shaji Kumar
Journal: American Journal of Hematology (2022)

Infections are a major cause of morbidity and mortality in multiple myeloma. The increased risk for bacterial and viral infections results mainly from the disease-inherent and treatment-induced immunosuppression. Additional risk factors are older age with immune senescence, T cell depletion, polymorbidity, and male gender. Hence, every effort should be taken to reduce the risk for infections by identifying patients at higher risk for these complications and by implementing prophylactic measures, including chemoprophylaxis and immunization against various relevant pathogens. Here, we review the available evidence and provide recommendations for medical prophylaxis and vaccination in clinical practice.
Error in Supplement 2
Journal: JAMA Network Open (2022)

Bart M. Demaerschalk, MD, MSc; Andrew Pines, MD; Richard Butterfield, BS, MA; Jack M. Haglin, MD; Tufia C. Haddad, MD; James Yiannias, MD; Christopher E. Colby, MD; Sarvam P. TerKonda, MD; Steve R. Ommen, MD; Matthew S. Bushman, BSc; Troy G. Lokken, MBA; Rebecca N. Blegen, MBA; Mekenzie D. Hoff, MSW; Jordan D. Coffey, MBA, MHA, MA; Greg S. Anthony, MBA, MSPH; Nan Zhang, MSc; Diagnostic Accuracy of Telemedicine Utilized at Mayo Clinic Alix School of Medicine Study Group Investigators; Stephanie Anaya; Jake Arbon; Nicholas Berry; Adip Bhargav; Lauren Breslin; Gabrielle Cummings; Sam Ekstein; Cecilia Fung; Benjamin Gorman; Maya Harrington; James Hwang; Tyler Jarvis; Monica Kirollos; Meg Lang; Rachel Lopdrup; Sheila Malekian; Parth Pradip Patel; Jordan Pollock; Alex Roth; Hiba Saifuddin; Serena Shimshak; Daniel Sykora; Caitlin VanLith; Samantha Wilder; Samuel Wu
Association of Particulate Matter Exposure With Lung Function and Mortality Among Patients With Fibrotic Interstitial Lung Disease
Authors: Gillian C. Goobie, Christopher Carlsten, Kerri A. Johannson, Nasreen Khalil, Veronica Marcoux, Deborah Assayag, Hélène Manganas, Jolene H. Fisher, Martin R. J. Kolb, Kathleen O. Lindell, James P. Fabisiak, Xiaoping Chen, Kevin F. Gibson, Yingze Zhang, Daniel J. Kass, Christopher J. Ryerson, S. Mehdi Nouraie
Journal: JAMA Internal Medicine (2022)

Particulate matter 2.5 μm or less in diameter (PM2.5) is associated with adverse outcomes for patients with idiopathic pulmonary fibrosis, but its association with other fibrotic interstitial lung diseases (fILDs) and the association of PM2.5 composition with adverse outcomes remain unclear.
Interventions Associated With Reduced Loneliness and Social Isolation in Older Adults
Authors: Peter Hoang, James A. King, Sarah Moore, Kim Moore, Krista Reich, Harman Sidhu, Chin Vern Tan, Colin Whaley, Jacqueline McMillan
Journal: JAMA Network Open (2022)

Importance Loneliness and social isolation are public health concerns faced by older adults due to physical, cognitive, and psychosocial changes that develop with aging. Loneliness and social isolation are associated with increased morbidity and mortality. Objective To evaluate interventions, targeting older adults, associated with a reduction in loneliness and social isolation. Data Sources OVID, CINAHL, CENTRAL, Embase, PsychINFO, Web of Science, and Scopus were searched from inception to March 2020. Study Selection Peer-reviewed randomized clinical trials measuring loneliness and social isolation or support in adults aged 65 years or older. Only English language articles were included. Data Extraction and Synthesis Two independent reviewers screened studies, extracted data, and assessed risk of bias. Random-effects models were performed to pool the overall effect size by intervention. Statistical heterogeneity was evaluated with the I 2 statistic and by estimating prediction intervals. Data were analyzed from November 2021 to September 2022. Main Outcomes and Measures Quantitative measures of loneliness, social isolation, or social support based on an effect size of standardized mean differences. Results Seventy studies were included in the systematic review (8259 participants); 44 studies were included in the loneliness meta-analysis (33 in the community with 3535 participants; 11 in long-term care with 1057 participants), with participants’ ages ranging from 55 to 100 years. Study sizes ranged from 8 to 741 participants. Interventions included animal therapy, psychotherapy or cognitive behavioral therapy, multicomponent, counseling, exercise, music therapy, occupational therapy, reminiscence therapy, social interventions, and technological interventions. Most interventions had a small effect size. Animal therapy in long-term care, when accounting for studies with no active controls, had the largest effect size on loneliness reduction (−1.86; 95% CI, −3.14 to −0.59; I 2 = 86%) followed by technological interventions (videoconferencing) in long-term care (−1.40; 95% CI, −2.37 to −0.44; I 2 = 70%). Conclusions and Relevance In this study, animal therapy and technology in long-term care had large effect sizes, but also high heterogeneity, so the effect size’s magnitude should be interpreted with caution. The small number of studies per intervention limits conclusions on sources of heterogeneity. Overall quality of evidence was very low. Future studies should consider measures of social isolation in long-term care and identify the contextual components that are associated with a reduction in loneliness.
Association Between Angiotensin Receptor Blocker Therapy and Incidence of Epilepsy in Patients With Hypertension
Authors: Corinna Doege, Mark Luedde, Karel Kostev
Journal: JAMA Neurology (2022)

Arterial hypertension is associated with an increased incidence of epilepsy. Results from animal studies suggest that angiotensin receptor blocker (ARB) therapy could inhibit epileptic seizures. However, there is a lack of clinical data to support the use of ARB therapy in humans.To assess whether ARB therapy is associated with a decreased incidence of epilepsy in patients with hypertension.This cohort study obtained data from the Disease Analyzer database (IQVIA) on patients aged 18 years or older who had hypertension and at least 1 antihypertensive drug prescription. Patients were treated at 1274 general practices between January 2010 and December 2020 in Germany. Data were available for 1 553 875 patients who had been prescribed at least 1 antihypertensive drug. Patients diagnosed with epilepsy before or up to 3 months after the index date were excluded. A total of 168 612 patients were included in propensity score matching. Patients treated with 1 of 4 antihypertensive drug classes (β-blockers, ARBs, angiotensin-converting enzyme inhibitors, and calcium channel blockers [CCBs]) were matched to each other using propensity scores.The main outcome of the study was the incidence of epilepsy associated with ARB therapy compared with other antihypertensive drug classes. Cox regression models were used to study the association between the incidence of epilepsy and ARBs compared with all other antihypertensive drug classes as a group.The study included a total of 168 612 patients, with 42 153 in each antihypertensive drug class. The mean [SD] age of patients was 62.3 [13.5] years, and 21 667 (51.4%) were women. The incidence of epilepsy within 5 years was lowest among patients treated with ARBs (0.27% at 1 year, 0.63% at 3 years, 0.99% at 5 years) and highest among patients receiving β-blockers and CCBs (0.38% for both β-blockers and CCBs at 1 year; 0.91% for β-blockers and 0.93% for CCBs at 3 years; β-blockers, 1.47%; and CCBs, 1.48% at 5 years). Angiotensin receptor blocker therapy was associated with a significantly decreased incidence of epilepsy (hazard ratio, 0.77; 95% CI, 0.65-0.90) compared with the other drug classes as a group.In this cohort study of patients with hypertension, ARB therapy was associated with a significantly decreased incidence of epilepsy. The findings suggest antihypertensive drugs could be used as a novel approach for preventing epilepsy in patients with arterial hypertension.
Anatomical Evidence for Parasympathetic Innervation of the Renal Vasculature and Pelvis
Authors: Xiaofeng Cheng, Yongsheng Zhang, Ruixi Chen, Shenghui Qian, Haijun Lv, Xiuli Liu, Shaoqun Zeng
Journal: Journal of the American Society of Nephrology (2022)

The kidneys critically contribute to body homeostasis under the control of the autonomic nerves, which enter the kidney along the renal vasculature. Although the renal sympathetic and sensory nerves have long been confirmed, no significant anatomic evidence exists for renal parasympathetic innervation.We identified cholinergic nerve varicosities associated with the renal vasculature and pelvis using various anatomic research methods, including a genetically modified mouse model and immunostaining. Single-cell RNA sequencing (scRNA-Seq) was used to analyze the expression of AChRs in the renal artery and its segmental branches. To assess the origins of parasympathetic projecting nerves of the kidney, we performed retrograde tracing using recombinant adeno-associated virus (AAV) and pseudorabies virus (PRV), followed by imaging of whole brains, spinal cords, and ganglia.We found that cholinergic axons supply the main renal artery, segmental renal artery, and renal pelvis. On the renal artery, the newly discovered cholinergic nerve fibers are separated not only from the sympathetic nerves but also from the sensory nerves. We also found cholinergic ganglion cells within the renal nerve plexus. Moreover, the scRNA-Seq analysis suggested that acetylcholine receptors (AChRs) are expressed in the renal artery and its segmental branches. In addition, retrograde tracing suggested vagus afferents conduct the renal sensory pathway to the nucleus of the solitary tract (NTS), and vagus efferents project to the kidney.Cholinergic nerves supply renal vasculature and renal pelvis, and a vagal brain-kidney axis is involved in renal innervation.
A tumor immune microenvironment-related integrated signature can predict the pathological response and prognosis of esophageal squamous cell carcinoma following neoadjuvant chemoradiotherapy: A multicenter study in China
Authors: Peng Wu, Zhihui Zhang, Yongliang Yuan, Chaoqi Zhang, Guochao Zhang, Liyan Xue, Haijun Yang, Le Wang, Xiaoli Zheng, Yonglei Zhang, Yufen Yuan, Ruixue Lei, Zhaoyang Yang, Bo Zheng, Qi Xue, Nan Sun, Jie He
Journal: International Journal of Surgery (2022)